Individual provider · Type 1 NPI

Wallace Sprugeon Colvin Iv, MA

Professional Counselor · Chicago, IL

NPI number 1699490284 Active

Practice location

2755 N Pine Grove Ave
Chicago, IL 60614-6109

Call (312) 259-2665 Map

Mailing address

500 E 33rd St Apt 810
Chicago, IL 60616-4239

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500XNone listed

Professional Counselor: Definition to come...

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About NPI 1699490284

Wallace Sprugeon Colvin Iv, MA's National Provider Identifier is 1699490284, issued on Oct 6, 2022. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Oct 6, 2022.